Moderate Training Research Articles

Multi-Source Satellite Imagery and Machine Learning for Detecting Geological Formations in Cameroon’s Western Highlands

Accurate identification of geological formations is essential for understanding tectonic structures, planning mining activities, and sustainably managing natural resources. It goes beyond the scientific framework to play a key role in economic development, environmental preservation, and population security. This article proposes a study using machine learning to analyze different parameters from various sources of satellite imagery: multispectral optics (Landsat-8), radar (ALOS PALSAR), and soil and morphometric parameters (soil, altitude, slope, curvature, and shady). The data were preprocessed to remove atmospheric biases and harmonize spatial resolutions. Techniques such as principal component analysis, band ratios, and image fusion have made it possible to enrich imagery by highlighting spectral and textural characteristics. Finally, classifiers such as Random Forest, Gradient Boosting, and XGBoost (version 1.6.2) were used to evaluate the impact of each parameter on the classification. The results show that geographic parameters combined with PCA provide the best overall performance with Random Forest, achieving an accuracy of 55.29% and an MCC of 45.12% while ensuring a rapid training speed (3.6 s). The geographic parameters associated with the OLI spectrometric data show a good balance, with XGBoost achieving a slightly higher MCC (40.3%) with a moderate training time (7.9 s). On the other hand, the OLI spectrometric parameters coupled with PCA display significantly lower performance, with an accuracy of 45.05% and an MCC of 31.81% for Random Forest. These observations highlight the potential of geographic and geological parameters associated with suitable models to improve classification. The multi-source approach thus proves optimal for more robust and precise results.

Multimodal prehabilitation in people awaiting acute inpatient cardiac surgery: Study protocol for a pilot feasibility trial (PreP-ACe).

The concept of "prehabilitation," or optimising individual physical and mental wellbeing prior to surgery is well established in cancer and orthopaedic populations. However, amongst the cardiac surgery population, the concept is relatively new. Of the few studies available, all focus on the elective surgical population. This pilot feasibility trial is novel as it will focus on the impact of multimodal prehabilitation on the acute inpatient cardiac surgical population. This single centre, prospective, single arm pilot feasibility trial will recruit 20 inpatients awaiting cardiac surgery. Measurements will be collected at the start of the trial (baseline), 7 days after intervention, and 14 days after the intervention or before the day of surgery. The primary outcome measure will be feasibility and practicality of the programme in an acute inpatient population. We will be looking into participant eligibility, acceptability, recruitment rates, completion rates and barriers to implementing a prehabilitation programme. Secondary outcomes include incidence of study-related adverse events, improvement in 6 minutes walk test (6MWT), hand grip strength, quality of life, anxiety scores and spirometry. At the end of the trial, we will be seeking the feedback of the participants on key components of the programme to help us inform future work. We hypothesise that light to moderate structured exercise training is low risk and feasible in patients awaiting inpatient cardiac surgery. The study was approved by Health Research Authority and Heath and Care Research Wales (Yorkshire & the Humber- Bradford Leeds Research Ethics Committee: REC reference 23/YH/0255) on the 8th November 2023. Multimodal prehabilitation could improve individual physical and mental wellbeing whilst awaiting inpatient cardiac surgery. Prehabilitation can provide individuals with a sense of ownership and control over their condition, improve their motivation and independence, and enhance their mental and physical recovery after surgery. Traditionally, patients waiting for cardiac surgery are discouraged from physical activity/ structured exercise training and receive limited information regarding their health. Appropriate physical and psychological support could improve their confidence to mobilise sooner after surgery. This may then facilitate earlier discharge leading to improved hospital bed utilisation and patient flow. ClinicalTrials.gov NCT06275100.

Impact of exercise training in a hypobaric/normobaric hypoxic environment on body composition and glycolipid metabolism in individuals with overweight or obesity: a systematic review and meta-analysis

ObjectiveThis study aims to assess the impact of hypoxia training on body composition and glycolipid metabolism in excess body weight or living with obese people through meta-analysis.MethodsRandomized controlled trials investigating the effects of hypoxia training on body composition, glucose, and lipid metabolism in excess body weight or living with obese people were systematically searched from databases including CNKI, PubMed, and Web of Science. The meta-analysis was performed by using Stata 18 and RevMan 5.4 analytic tools. The risk of bias was assessed using the Cochrane evaluation tool, and the level of certainty of evidence was determined by the GRADE framework. Between-study heterogeneity was examined using the I2 test, and the publication bias was evaluated via the Egger test or funnel plot.ResultsA total of 32 RCTs with 1,011 participants were included. A meta-analysis of 25 RCTs was performed (499 men and 480 women, Age: 40.25 ± 15.69, BMI: 30.96 ± 3.65). In terms of body composition, the outcome indexes of body fat ratio (MD is −1.16, 95% CI -1.76 to −0.56, P = 0.00) in the hypoxia group were better than the normal oxygen group. There was no significant difference in body mass and BMI between the hypoxia group and the normal-oxygen group (P > 0.05). In terms of lipid and glucose metabolism, no significant changes were found between the hypoxia group and the normoxia group (P > 0.05). Subgroup analysis showed that training in hypoxic environment at altitude 2001–2,500 m could effectively improve body mass, TG and LDL-C (P < 0.05). The effective program to reduce body mass is to carry out moderate intensity training of 45–60 min for ≤8 weeks, ≥4 times a week (P < 0.05).ConclusionHypoxic training is essential for reducing body fat ratio in excess body weight or obese people. It is recommended to carry out 45–60 min of moderate-intensity aerobic exercise for ≤8 weeks, ≥4 times a week, in a hypoxia environment of 2,001–2,500 m to lose body mass. The effects of hypoxia training and normoxia training on lipid and glucose metabolism in excess body weight or obese people are the same.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD42024628550

Using EEG Microstates to Examine Whole-Brain Neuronal Networks During Offline Rest Consolidation after Visual Perceptual Learning.

Using EEG Microstates to Examine Whole-Brain Neuronal Networks During Offline Rest Consolidation after Visual Perceptual Learning.

Training method and difficulty modulate electrophysiological correlates of visual perceptual learning.

Training method and difficulty modulate electrophysiological correlates of visual perceptual learning.

The effects of normobaric hypoxic resistance training on muscle strength in healthy adults.

Following PRISMA 2020 guidelines, four databases (PubMed, Web of Science, SportDiscus, and CNKI) were searched from inception to October 25, 2024, for randomized controlled trials. Study quality was assessed using the Cochrane Risk of Bias tool. Effect sizes were calculated using Review Manager 5.4. A total of 22 RCTs involving 487 healthy adults were included. The meta-analysis revealed a significant small-to-moderate improvement in 1RM (SMD = 0.22, 95% CI [0.06, 0.38]) but no statistically significant effects on isometric strength (SMD = 0.32, 95% CI [-0.05, 0.70]) and isokinetic strength (SMD = 0.25, 95% CI [-0.11, 0.62]). Subgroup analyses indicated that oxygen concentrations of 14-16% and training loads of 60-80% 1RM produced the most substantial gains, particularly among untrained participants. NHRT is a promising strategy for enhancing 1RM in healthy adults, with its effectiveness influenced by hypoxic levels, training load, and baseline training status. Optimal outcomes were observed at oxygen concentrations of 14-16% and moderate training loads (60-80% 1RM), particularly in untrained individuals. Further high-quality studies are warranted to confirm these outcomes and explore the underlying mechanisms.Registration number on PROSPEROCRD42024547100.

No long-term benefits from resistance training on brain grey matter volumes in active older adults at retirement age

BackgroundResistance training and other forms of physical exercise are commonly suggested to promote brain health, yet the relationship between resistance training and brain structure in aging is poorly understood. We examined the short- and long-term influence of one year of supervised resistance training at two different loadings on brain structure in aging.MethodsIn the LISA (LIve active Successful Ageing) study, well-functioning older adults at retirement age (mean age: 66 ± 2 years) were randomized to one year of heavy resistance training (HRT), moderate intensity training (MIT), or a non-exercising control group (CON). Magnetic resonance imaging (MRI) of the brain was performed at baseline, 1-, 2-, and 4-years follow ups. Trajectories of total grey matter, hippocampus, dorsolateral prefrontal cortex (dlPFC), ventrolateral prefrontal cortex (vlPFC), and white matter hyperintensities were analyzed in relation to changes in muscle strength.ResultsIndividuals (n = 276) with MRI scans at all 4 timepoints were included (HRT, n = 96; MIT, n = 95; CON, n = 85). Total grey matter volume decreased with time across all groups (F3,819 = 231.549, p < 0.001, η2 = 0.46), as did hippocampal (F3,819 = 310.07, p < 0.001, η2 = 0.53), vlPFC (F3,818 = 74.380, p < 0.001, η2 = 0.21), and dlPFC (F3,818 = 3.640, p = 0.013, η2 = 0.01) volumes. White matter hyperintensity volumes increased (F3,819 = 101.876, p < 0.001, η2 = 0.27). There were no significant group x time interactions for any of the brain structures. Additional cortical and subcortical vertex-wise analyses showed no group differences. Change in isometric leg strength was weakly associated with change in white matter hyperintensity volume across all individuals (r2 = 0.01, p = 0.048).ConclusionsOne year of resistance training in well-functioning older adults at retirement age did not influence volume changes in selected brain regions over a 4-year period.Trial registrationThe study was approved by the regional ethics committee and registered on clinicaltrials.gov 2014–04-24 (NCT02123641).

Effect of Parallel Cognitive-Motor Training Tasks on Hemodynamic Responses in Robot-Assisted Rehabilitation.

Objective: Previous studies suggest that the combination of robot-assisted training with other concurrent tasks may promote the functional recovery and improvement better than the single task. It is well-established that robot-assisted rehabilitation training is effective. This study aims to characterize the neural mechanisms and inter-regional connectivity changes associated with robot-assisted parallel interactive training tasks. Methods: Twenty-five healthy young adults (12 females and 13 males) participated in three number-related cognitive-motor parallel interactive training tasks categorized by difficulty: low difficulty (LD), medium difficulty (MD), and high difficulty (HD). Functional near-infrared spectroscopy was used to measure neural responses in the primary sensorimotor cortex (SM1), supplementary motor area (SMA), and prefrontal cortex (PFC). Activation maps and functional connectivity (FC) correlation matrix maps were applied to assess cortical response and connectivity among channels and regions of interest. Results: Significant differences were observed in both activation and connectivity results across the three training conditions. Stronger activation (p < 0.01) in oxy-hemoglobin was found in the MD conditions, with activation in the HD condition being stronger than in the LD condition. The FC in the PFC increased linearly with rising training difficulty. Trends in FC for SM1 and SMA were consistent with the activation results. Conclusions: In parallel training tasks of varying difficulty, MD stimulates more neural activity and promotes stronger network connections in the brain. This study enhances the understanding of the neurological processes involved in robot-assisted parallel interactive tasks and may inform more effective robot-assisted rehabilitation therapies. Impact Statement This study aims to characterize the neural mechanisms and inter-regional connectivity changes of robot-assisted parallel interactive training tasks when coping with changes in task difficulty. It presented an initial increase in activation and connectivity, but a decreasing trend when the excessive load was involved. Moderate difficulty training may stimulate more neural activity and network connections of the brain because it is challenging and acceptable. Our results suggest a relatively optimal condition for the implementation of robot-assisted rehabilitation in terms of training difficulty. It may provide a reference for more effective robot-assisted rehabilitation therapy.

Training-induced change of diastolic function in heart failure with preserved ejection fraction.

Exercise training improves aerobic capacity (V̇O2peak) in patients with heart failure and preserved ejection fraction (HFpEF), but underlying mechanisms remain unclear. We aimed to evaluate whether exercise training could improve systolic and diastolic function during exercise. This was a substudy of the multicentre Optimizing Exercise Training in HFpEF (OptimEx-Clin) trial, in which 180 patients with HFpEF were randomized 1:1:1 to guideline control, moderate continuous training or high-intensity interval training. All patients included at two out of five participating sites underwent exercise echocardiography at baseline and 3months. Patients of both training groups were pooled and compared with guideline control. A total of 61 patients (mean age 73±7years, 72% female) were included. At baseline, E/e' increased from 17.0±5.7 to 19.5±6.1 and systolic pulmonary artery pressure from 31±8 to 51±11mmHg (both P<0.001). Right ventricular function did not change significantly (maximal tricuspid annular plane systolic excursion 24.7±4.0mm, P=0.051 vs. baseline). At 3months, patients randomized to exercise training improved V̇O2peak (control +0.2, training +2.7mL/kg/min, P=0.006) and demonstrated small but significant improvements in exercise E/e' (control 21.7±7.5 to 22.8±9.2, training 18.3±5.0 to 17.2±4.1, P=0.044). No significant changes were observed in ejection fraction, mitral or tricuspid annular plane systolic excursion, S', A' or systolic pulmonary artery pressure (P>0.05). Changes in E/e' were not associated with the change in V̇O2peak. In patients with HFpEF, exercise echocardiography revealed increases in filling pressures as well as a failure to augment right ventricular function during exercise. After 3months of exercise training, HFpEF patients demonstrated a small improvement in diastolic function (exercise E/e'), but this did not explain the improved aerobic capacity.

The Relationship of Physical Activity to Anxiety and Resilient Coping Among Higher Education Employees

Background: Physical activity (PA) can positively affect mental health, yet many aspects of this relationship (degree of effectiveness across populations and conditions, biological mechanisms, etc.) remain unexplored. Aim: This study seeks to understand how PA is associated with anxiety, a common mental health condition, and resilient coping, the ability of an individual to overcome personal stress; and, how PA can be utilized to alleviate anxiety and strengthen resilient coping. Methods: Data collected from Health Assessment surveys assessed how several types of PA (moderate, vigorous, moderate-to-vigorous, and strength training) are related to anxiety and resilient coping. Results: Analysis revealed statistically significant relationships between PA and anxiety and PA and resilient coping. The findings from this study establish positive associations between PA and anxiety and resilient coping, emphasizing the powerful influence of PA as a mental health therapeutic. Such results suggest that PA could become a key component for attenuating mental health crises of workforces within higher education institutions. Conclusion: These findings serve as convincing evidence that organizations should assess ways to incorporate PA into their policies and programs for the health and well-being of employees, namely those of higher education institutions.

Effects of Supramaximal Intensity Interval Training on Resistin and Cardiometabolic Health Indices in Overweight Nonpostmenopausal Women.

Adipose tissue is an endocrine organ that produces various bioactive molecules known as adipokines, including resistin, which is be highly expressed in people with obesity and cardiovascular disease (CVD). The effects of supramaximal high intensity interval training (HIIT) and moderate-intensity interval training (MIIT) on serum levels of resistin and various cardiometabolic health indices, were investigated. Supramaximal and moderate interval training induce comparable effects on serum resistin levels and cardiometabolic health indices. Cohort study. Thirty overweight adult women were assigned to 1 of 3 groups: HIIT (2 sets of 8 intervals, each with 30 seconds exercise at 100%-110% maximal aerobic speed [MAS] followed by 30 seconds rest at 50% MAS; for 6 weeks with 3 sessions per week), MIIT (2 sets of 8 intervals, each with 30 seconds exercise at 70%-80% MAS followed by 30 seconds rest at 50% MAS; for 6 weeks with 3 sessions per week), or a control group. Triglyceride levels were significantly higher in the control group compared with both the HIIT and MIIT groups (P = .02 and .01, respectively). High-density lipoprotein levels were also elevated significantly in the experimental groups compared with the control group (P = .04 and .03, respectively). Serum resistin increased significantly from pretest levels in the control group (P < .01). Between-group comparisons showed that resistin levels were significantly higher in the control group than in the experimental groups (P < .01 and .01, respectively). Six weeks of HIIT can reduce resistin levels and improve cardiometabolic health indicators in nonpostmenopausal women. Although 6 weeks of MIIT does not reduce resistin, it does decrease systolic blood pressure and obesity-related factors in nonmenopausal women. Supramaximal interval training may be recommended to control bioactive molecules produced from adipose tissue that are linked to CVD.

Acute effects of physical exercise on cognitive function and neurotrophins in patients with type 1 diabetes: A systematic review.

Acute effects of physical exercise on cognitive function and neurotrophins in patients with type 1 diabetes: A systematic review.

Steady Moderate Exercise Confers Resilience Against Neurodegeneration and Neuroinflammation in a Mouse Model of Parkinson's Disease.

Intensive aerobic exercise slows the progression of movement disorders in Parkinson's disease (PD) and is therefore recommended as an important component of treatment for PD patients. Studies in animal models of PD have shown that vigorous exercise has neuroprotective effects, and emerging evidence suggests that it may be a disease-modifying treatment in humans. However, many people with PD may not be able to participate in vigorous exercise because of multiple medical conditions that severely limit their physical activity. In this study, we have shown that chronic MPTP treatment in sedentary mice resulted in loss of dopaminergic neurons in the SNpc, decreased levels of neurotrophins, BDNF and GDNF, and increased levels of inflammatory markers and pro-inflammatory changes in immunocompetent cells. Moderate exercise, initiated both before and after chronic MPTP treatment, significantly attenuated the loss of dopaminergic neurons and increased BDNF and GDNF levels even above those in sedentary control mice. No signs of inflammation were observed in MPTP-treated mice, either when training began before or after MPTP treatment. Training induced beneficial changes in the dopaminergic system, increased levels of neurotrophins and suppression of inflammation were similar for both steady moderate (present data) and intense training (our previously published data). This suggests that there is a kind of saturation when the percentage of rescued dopaminergic neurons reaches the highest possible value, and therefore further increases in exercise intensity do not enhance neuroprotection. In conclusion, our present results compared with the previous data show that increasing exercise intensity beyond the level used in this study does not increase the neuroprotective effect of aerobic training in a mouse model of Parkinson's disease.

Physiological differences in cardiopulmonary exercise testing between children and adults

Purpose: This study examines age- and sex-related physiological differences in cardiopulmonary exercise testing (CPET) between children and adults, focusing on ventilatory thresholds (VT) and oxygen uptake efficiency slope and plateau (OUES; OUEP). Methods: The cross-sectional analysis comprised 24 children (7–11 years), 20 moderately- trained (MTA) and 20 well-trained (WTA) adults (20–30 years). They performed a maximal CPET on a cycle ergometer, while respiratory responses were measured. Linear regression models analyzed differences by age and sex of the key outcome parameters VT1, VT2, OUES and OUEP. Results: Children exhibited higher absolute VO2 at VT1 (d=.66) and VT2 (d=.58) values than MTA but slightly lower VO2 at VT2 values compared to WTA (d=.35). Adults demonstrated higher OUES (MTA: d=.37; WTA: d=1.45) and OUEP (MTA: d=.81; WTA: d=.60) values than children. However, children had higher relative OUES when adjusted for body mass (OUESrel) (MTA: d=.1.80; WTA: d=.87). Males demonstrated higher values as females for VO2 at VT2 (d=.81), OUES (d=.79) and OUEP (d=.41), respectively. In contrast, females had higher VO2 at VT1 (d=.59) and VT2 (d=.44) relative to VO2peak as males. Conclusion: These findings suggest that compared to adults, children rely more on oxidative metabolism, reflected in higher ventilatory thresholds relative to their aerobic capacity. Absolute OUES and OUEP increased with age, but OUESrel values indicate that maturation influences efficiency more than body mass, reflecting underlying metabolic and physiological differences. These age- and sex-specific patterns highlight the need for further longitudinal research to clarify the roles of growth and training on these parameters.

Cardiac myosin binding protein C correlate with cardiac troponin I during an exercise training program in patients with HFrEF.

Cardiac myosin binding protein C (cMyC) is an emerging new biomarker of myocardial injury rising earlier and cleared faster than cardiac troponins. It has discriminatory power similar to high-sensitive troponins in diagnosing myocardial infarction in patients presenting with chest pain. It is also associated with outcome in patients with acute heart failure. It is currently unclear how it relates to cardiac troponins in patients with chronic heart failure undergoing exercise training. This is a post hoc analysis of symptomatic heart failure patients in the multicentre randomized SMARTEX trial. Patients were randomized to one of three arms: high-intensity interval training, moderate continuous training and recommendation of regular exercise serving as control group (CG) for 12weeks. As the training load in the two intervention arms was similar, these patients were merged and constituted the intervention group (IG). Clinical data and measurements were obtained at baseline and at 12weeks. In 205 patients, serum was available for cMyC testing and in 196 patients, serum was available for hs-cTni testing. Due to non-normal distribution, cMyC and hs-cTnI measurements were log-transformed. A Bland-Altman plot was employed to evaluate the agreement of cMyC with hs-cTnI measurements. Lastly, a linear regression model was applied. No significant differences were observed in the change of cMyC levels between the groups throughout the intervention period (∆ cMyC IG: -0.5 [IQR: -3.4; 2.1] vs. ∆ cMyC CG: -0.7 [IQR: -2.7; 2.6]). The change in log hs-cTnI was significantly correlated with the change in log cMyC during the 12-week intervention period, with a Pearson correlation coefficient of R=0.52 (95% CI 0.37-0.66, P<0.001). For every 10% increase in cMyC levels, hs-cTnI levels rose by approximately 5%. Changes in levels of the novel biomarker cMyC were significantly associated with hs-cTnI serum levels in patients with symptomatic chronic HFrEF during a structured 12-week exercise training programme. This may indicate that cMyC has a role as a future marker of subclinical myocardial damage.

Impact of combiner aerobic and resistance training on depression: a systematic review and meta-analysis of randomized controlled trials

ObjectiveTo summarize the existing literature and evaluate the efficacy of combined resistance and aerobic training in alleviating depressive symptoms among individuals with depression. Subgroup analyses were conducted based on study region, age, depression severity, intervention duration, intervention frequency, and whether the intervention was supervised or unsupervised.MethodsFive databases were thoroughly examined from database establishment until August 20, 2024, to find randomized controlled trials that investigated resistance combined aerobic training impact on depression.ResultsFinally, 27 eligible studies were included, involving a total of 2,342 patients with depression. The outcomes indicated that resistance combined aerobic training notably improved signs of depression in these patients (SMD=-1.39, 95%CI=-1.80 to -0.96, p = 0.000). Subgroup analysis based on study area, age, severity of depressive symptoms, and exercise prescription revealed that resistance combined aerobic training had a particularly significant effect on middle-aged and elderly patients with depression, as well as on those with moderate depression. Additionally, moderate period (9–24 weeks), moderate frequency (3–4 times per week), a total weekly duration of more than 180 min and supervised training displayed the best results.ConclusionResistance combined aerobic training serves as an efficient approach to relieve depression-related symptoms, particularly in middle-aged and elderly patients with depression and those with moderate depression. Moderate training intensity, duration, frequency, and total weekly duration offer the greatest benefit.

Sports Programs for Mental Illness: How Mental Health Professionales Can Provide Effective Support

Despite the positive effects of physical activity, people with mental illness often remain inactive. Exercise recommendations are inconsistent and challenging to follow.This study assessed exercise behavior and the need for programs during and after inpatient treatment to develop clinical recommendations.Patients from the psychiatric clinic at the University of Augsburg were recruited via flyer/QR-Code.A total of 47 patients participated in this survey. Over 70% exercise regularly, and over 70% are interested in peer-sports-groups with low-threshold conditions (e.g. no prior registration required). Strength training and moderate intensity training were favored over endurance sports.Our findings complement the World Health Organization's exercise recommendations. Strength training programs and accessible options may promote physical activity in this population.

Heavy resistance training provides short-term benefits on bone formation in well-functioning older adults.

Heavy resistance training provides short-term benefits on bone formation in well-functioning older adults.

Energy availability and macronutrient intake over a 7-day training period in adolescent rugby players.

Understanding the dietary intake of elite adolescent athletes and its adequacy with sport nutrition recommendation is a key issue for health and player development, as well as performance and recovery. Energy availability needs to be considered to ensure optimal health and performance in young athletes. The present study aimed to quantify energy availability, energy expenditure and macronutrient intake in young male rugby union players competing at national level. Twelve male adolescent players (15.6±0.6 years) completed a 7-days prospective observational study (5 days of training and 2 days of full recovery). Total energy expenditure was estimated using indirect calorimetry and heart rate measurement. Energy intake was assessed using weighed food by a dietitian in cafeteria (training days) and image-based dietary (recovery days). Energy availability was calculated using (energy intake-exercise energy expenditure)/fat-free mass. Mean energy availability was 38.5±7.5, 40.2±5.4 and 47.8±5.1 kcal/kgFFM/d on heavy training, moderate training and recovery days, respectively. Players consumed a low carbohydrate (~5.0 g/kg/d), high protein (~2.0 g/kg/d) and high fat (~1.8 g/kg/d) diet on training and recovery days in relation to current international nutritional recommendations for young athletes. Athletes showed sub-optimal energy availability on training days, high energy availability on recovery days and did not comply with carbohydrate intake recommendations on training nor recovery days. These results highlight the short-term inadequacy of energy availability as a result of low carbohydrate intake, warning about the possible adverse short-term metabolic effects on health and performance of young athletes.

Exercise Training in Heart Failure: Current Evidence and Future Directions.

Heart Failure (HF) is a prevalent condition which places a substantial burden on healthcare systems worldwide. Medical management implemented with exercise training (ET) plays a role in prognostic and functional capacity improvement. The aim of this review is to determine the effect of exercise training (ET) on HFpEF and HFrEF patients as well as exercise modality recommendations in frail and sarcopenic subpopulations. Pharmacological therapy structures the cornerstone of management in HF reduced ejection fraction (HFrEF) and aids improved survival rates. Mortality reduction with pharmacological treatments in HF preserved ejection fraction (HFpEF) are yet to be established. Cardiac rehabilitation (CR) and ET can play an important role in both HFrEF and HFpEF. Preliminary findings suggest that CR significantly improves functional capacity, exercise duration, and quality of life. ET has shown beneficial effects on peak oxygen consumption (pVO2) and 6 min walk test distance in HFrEF and HFpEF patients, as well as a reduction in hospitalisation and mortality rates; however, the limited scope of larger trials reporting on this underscores the need for further research. ET also has been shown to have beneficial effects on depression and anxiety levels. High-intensity training (HIT) and moderate continuous training (MCT) have both shown benefits, while resistance exercise training and ventilatory assistance may also be beneficial. ET adherence rates are higher when enrolled to a supervised programme, but prescription rates remain low worldwide. Larger robust trials are required to determine ET's effects on HF, as well as the most efficacious and personalised exercise prescriptions in HF subtypes.